摘要
目的:探讨能谱计算机断层扫描(CT)的曲线斜率、CT值与脊柱骨转移瘤患者血管新生及预后的关系。方法:选取平煤神马集团总医院2021年7月至2022年3月收治的脊柱骨转移瘤患者78例,根据肿瘤组织微血管密度(MVD)分为高密度组(32例)、低密度组(46例),比较两组患者的能谱CT曲线斜率、CT值,分析能谱CT测定的曲线斜率、CT值与MVD的相关性;随访6个月后,比较不同预后患者入院时、入院1个月、3个月后能谱CT曲线斜率、CT值,分析其对脊柱骨转移瘤预后的评估预测价值。结果:与低密度组患者比较,高密度组的能谱CT曲线斜率、CT值均较高;与生存患者比较,病死患者入院时、入院1个月后能谱CT曲线斜率、CT值较高;差异均具有统计学意义(P<0.05)。经相关性分析,MVD与能谱CT曲线斜率(r=0.725,P<0.001)、CT值(r=0.763,P<0.001)均呈正相关;受试者工作特征曲线(ROC)分析结果显示,患者入院1个月后能谱CT曲线斜率、CT值对脊柱骨转移瘤患者病死预测曲线下面积(AUC)分别为0.784、0.760,二者联合预测AUC为0.927,高于单一指标预测;危险度分析结果显示,曲线斜率、CT值高水平患者的病死风险分别为低水平患者的3.833、4.778倍(P<0.05)。结论:能谱CT曲线斜率、CT值可用于评估脊柱骨转移瘤血管形成,为临床早期预测预后提供参考,以针对性展开后续治疗,改善预后。
Objective To investigate the relationship between the slope of spectral computed tomography(CT)curve,CT value and angiogenesis and prognosis in patients with spinal bone metastases.Methods A total of 78 patients with spinal bone metastases admitted to the General Hospital of Pingmei Shenma Group from July 2021 to March 2022 were selected.According to the microvessel density(MVD)of tumor tissue,they were divided into high density group(32 cases)and low density group(46 cases).The slope and CT value of the spectral CT curve were compared between the two groups,and the correlation between the slope and CT value of the spectral CT curve and MVD was analyzed.After 6 months of follow-up,the slope of spectral CT curve and CT value of patients with different prognosis were compared at admission,1 month and 3 months after admission,and their predictive value for the prognosis of spinal bone metastases was analyzed.Results Compared with the low-density group,the slope and CT value of the spectral CT curve in the high-density group were higher.Compared with the survival patients,the death patients had higher slope and CT value of spectral CT curve at admission and 1 month after admission;the differences were all statistically significant(P<0.05).The correlation analysis showed that MVD was positively correlated with the slope of spectral CT curve(r=0.725,P<0.001)and CT value(r=0.763,P<0.001).Receiver operating characteristic curve(ROC)analysis showed that,the area under the curve(AUC)of the slope of spectral CT curve and CT value in predicting the death of patients with spinal bone metastases was 0.784 and 0.760,respectively,the AUC of combined prediction was 0.927,higher than single index prediction;The results of risk analysis showed that the mortality risk of patients with high levels of curve slope and CT value was 3.833 and 4.778 times that of patients with low levels,respectively(P<0.05).Conclusion The slope of spectral CT curve and CT value can be used to evaluate the angiogenesis of spinal bone metastases.It provides a reference for clinical early prediction of prognosis,so as to carry out followup treatment and improve prognosis.
作者
孙淑钦
彭金平
田成斌
SUN Shu-qin;PENG Jin-ping;TIAN Cheng-bin(General Hospital of Pingmei Shenma Group,Henan Pingdingshan 467000)
出处
《深圳中西医结合杂志》
2023年第12期28-31,F0003,共5页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
